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[edit] Diet
See Saag and Choi, 2006, an open-access review article, for detailed references and further information.[31]
The serum level of uric acid is the primary risk factor for gout. The serum level is the result of both intake (diet) and output (excretion). Diet should be low fat and low protein.
[edit] Reduce intake of purines
The solubility threshold for uric acid is approximately 6.7 mg/dl; above this threshold crystals may form. Healthy subjects in the Normative Aging Study who had serum levels of uric acid over 9.0 mg/dl suffered a 22% incidence of gout over six years, compared to less than one percent for those with 7.0-8.9 mg/dl. The average uric acid level in men is 5.0 mg/dl, and substitution of a purine-free formula diet reduces this to 3.0 mg/dl. A purine-restricted diet lowers the level nearly as much (1-2 mg/dl).
A diet low in purines reduces the serum level of uric acid, unless these levels are caused by other health conditions and not as responsive to dietary changes. For notable sources of dietary purines, see "Foods to avoid" section below.
Protein is a crude proxy for purines; a more precise proxy is muscle. Apart from the notable dietary purines above, the main source of dietary purines is DNA and RNA, via their bases adenine and guanine. All sources of dietary protein supply some purines, but some sources provide far more purines than others. Meat (particularly dark meat) and seafood are high in purine because muscle cells are packed with mitochondria, which have their own DNA and RNA. In a large prospective study, high consumption of meat and seafood were found associated with an elevated risk of gout onset (41% and 50%, respectively). High consumption of dairy products, high in protein but very low in DNA and RNA, was associated with a 44% decrease in the incidence of gout. Consumption of the more purine-rich vegetables or a high protein diet per se had no significant correlation.
Men who consume two or more sugary soft drinks a day have an 85% higher risk of gout compared with those who drink less than one a month.[2] This is because soft drinks contain large quantities of high-fructose corn syrup (HFCS) (read label on any soft drink), which results in Hyperuricemia in blood.[32][33] Hyperuricemia, in turn predispose the body for gout.[34]
Consumption of beer is associated with a 49% increase in relative risk per daily 12-oz serving. By contrast, consumption of spirits was associated with only a 15% increase in relative risk, and no association at all was found with consumption of wine.
Some medical drugs are purine-based. Notable among these are the purine-analog antimetabolite drugs, sometimes used as chemotherapy agents.
[edit] Increase output of uric acid
As mentioned above, medicines to induce uric acid output are called uricosuric drugs. Two such drugs are Probenecid and Sulfinpyrazone.
[edit] Other approaches
Additional dietary recommendations can be made which reduce gout indirectly, hypertension, cardiovascular disease, diabetes, and metabolic syndrome.
The following suggestions do not meet with universal approval among medical practitioners.
Low purine diet:
To lower uric acid:
bing cherries were reported to reduce uric acid in a small study.[35][36]
celery extracts (celery or celery seed either in capsule form or as a tisane/infusion) is believed by many to reduce uric acid levels (although these are also diuretics).[citation needed] Celery extracts have been reported to act synergistically with anti-inflammatory drugs.[37]
Cheese has been recommended as a low-purine food,[38] and dairy products have been found to reduce the risk of gout.
Carbonated beverages and sugar have also been recommended as a low-purine food,[38] even though it was established that men who consume two or more sugary soft drinks a day have an 85% higher risk of gout compared with those who drink less than one a month.[3]
Dietary supplements Quercetin, a flavonoid, can decrease uric acid levels. Quercetin can be taken with bromelain to improve its absorption. In addition, Pantothenic acid (vitamin B5) is said to help with the excretion process of uric acid. [39]
Food to avoid:
foods high in purines
limit food high in protein such as meat, fish, poultry, or tofu to 8 ounces (226 grams) a day. Avoid entirely during a flareup.[citation needed] Tofu has been proposed as a safe source of protein for gout patients due to its small and transient effect on plasma urate levels.[40]
sweetbreads, kidneys, liver, brains, or other offal meats.[41][42]
sardines and anchovies[41]
seafood[24] particularly shellfish such as clam, oyster, scallop, shrimp, crab, lobster, and crayfish.
Asparagus. Cauliflower. Mushrooms. Spinach. (Even though above says "Consumption of the more purine-rich vegetables or a high protein diet per se had no significant correlation.")
Dry beans (lentils & peas).
alcohol.[43] Some claim that this applies especially to beer (high in guanosine), on the basis that brewer's yeasts are very rich in purine. Since most modern commercial beer contains only trace amounts of yeast, this claim requires further substantiation.[citation needed] Formerly, port wine was sweetened with litharge, causing lead poisoning, of which gout is a complication. Ironically, red wines, particularly those produced by traditional methods,[44] contain procyanidins released from grape seeds during wine making, which have been reported to lower serum uric acid levels by an indirect mechanism.[45] However, withdrawal of urate-lowering therapy is associated with recurrence of acute gouty arthritis.[46]
meat extracts, consommés, and gravies[41]
Foods high in fructose, as discussed above, especially high-fructose corn syrup (HFCS) as main ingredient (READ LABEL).[34]
All soft drinks (non-diet), wherein HFCS is second ingredient next to water
Fruit preserves, jam, jelly
Syrup
Candy
To lesser extent, depending on fructose content, ice cream, cakes, and cookies
To avoid dehydration:
Drink plenty of liquids, especially water, to dilute and assist excretion of urates;
Avoid diuretic foods or medicines like aspirin(aspirin should be avoided by those suffering from gout, unless specified by a qualified physician), vitamin C, tea and alcohol. The role of diuretics in triggering gout has been disputed.[14]
Moderate intake of purine-rich vegetables is not associated with increased gout.[24]
[edit] History
Nad S
Cherries, pistachios, prayer, it's all crap. Go to the doctor and get something that works. Diet, beer consumption, all of it is crap. You have to have protein, and anything that has protein has purines. True, you don't have to eat liver, but the main problem is getting your body to eliminate the uric acid. Otherwise it will eventually build up and cause flares no matter what you consume or don't.
Diane E
There are a lot of natural remedies you can use. Diet is all important and there is a lot of detail about it available if you research it on the internet. Bing cherries have proven to very helpful with gout relief.
Sex for men reduces the uric acid buildup - what better natural remedy is there than that?!
There are supplements and enzymes that can help. Some things work better for others than others. Again, I would recommend doing some reading about natural remedies and get a feel for what you want to try.
To your health and happiness,
Diane Ellen
Orignal From: what is the best home remedy for gout?
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